Provider Demographics
NPI:1134436751
Name:SPOONER, GREGORY J (DPT)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:J
Last Name:SPOONER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:19442 1ST AVE NE
Mailing Address - Street 2:
Mailing Address - City:POULSBO
Mailing Address - State:WA
Mailing Address - Zip Code:98370-7382
Mailing Address - Country:US
Mailing Address - Phone:619-363-2227
Mailing Address - Fax:619-354-1789
Practice Address - Street 1:7865 NE DAY RD W STE 202
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98110-6212
Practice Address - Country:US
Practice Address - Phone:360-860-3100
Practice Address - Fax:360-205-3587
Is Sole Proprietor?:No
Enumeration Date:2010-09-02
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist